XV - The Oral Cavity and the GI Tract Flashcards
Small, painful, rounded superficial erosions of the mouth, covered with a gray-white exudate and having an erythematous rim.
Aphthous ulcers (canker sores)(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 580
Extremely common infection caused by herpes simplex virus type 1.
Herpetic stomatitis(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 580
Test used to identify HSV infection.
Tzanck test(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 580
Glassy, intranuclear acidophilic inclusion bodies.
Herpes simplex virus(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 580
Adherent white, curd-like, circumscribed plaque within the oral cavity. The pseudomembrane can be scraped off revealing an underlying granular erythematous inflammatory base.
Oral candidiasis /”thrush”(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 581
An oral lesion seen in patients with HIV. White confluent patches with “hairy” or corrugated surface with marked epithelial thickening.
Hairy leukoplakia(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 581
Hairy leukoplakia is caused by what infectious agent?
Epstein-Barr virus(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 581
A whitish, well-defined mucosal patch or plaque caused by epidermal thickening or hyperkeratosis, commonly seen in the vermillion border of the lower lip, buccal mucosa, hard and soft palates.
Leukoplakia(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 581
Oral lesion showing a corrugated surface caused by excessive hyperkeratosis. Recurring and spreads insiduously, resulting in a warty-type lesion.
Verrucous leukoplakia(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 582
Red, velvety, granular, circumscribed lesions of the mouth with poorly defined, irregular boundaries. High malignant transformation rate.
Erythroplakia(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 582
Most frequent site of oral cavity carcinomas.
Vermillion border of the lateral margins of the lower lip(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 582
Pearly white to gray, circumscribed thickenings of the oral mucosa, which grows in exophytic pattern to produce a visible and palpable nodular, eventually fungating lesions.
Oral cavity carcinoma(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 583
Most common lesion of the salivary glands resulting from blockage or rupture of a salivary gland duct.
Mucocele(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 583
Inflammation of the salivary glands.
Sialadenitis(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 583
Salivary and lacrimal gland inflammatory enlargement presenting as painless lesions, and dry mouth. Can be caused by sarcoidosis, leukemia, and lymphoma.
Mikulicz syndrome(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 583
Incomplete relaxation of lower esophageal sphincter in response to swallowing.
Achalasia(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 585
Destruction of the myenteric plexus of the esophagus, duodenum, colon and ureter caused by a flagellate protozoa.
Chagas disease(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 585
Causative agent for Chagas disease.
Trypanosoma cruzi(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 585
Adult with progressive dysphagia to solids and eventually to all foods, caused by a narrowing of the lower esophagus, usually as a result of chronic inflammatory disease.
Stenosis(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 585
A congenital defect which causes the esophagus to end in a blind-ended pouch.
Esophageal atresia(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 585
Most common type of esophageal atresia.
Esophageal atresia with distal tracheoesophageal fistula(Type C)(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 585
Thin membranes of normal esophageal tissue consisting of mucosa and submucosa that can partially obstruct the esophagus.
Esophageal web(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 585
Congenital esophageal webs commonly appear in which segment of the esophagus?
Middle and inferior third of the esophagus(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 585
A diverticulum of the mucosa of the pharynx just above the cricopharyngeal muscle.
Zenker’s diverticulum(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 586
A triangular area in the pharyngeal wall where a Zenker’s diverticulum may develop.
Killian’s triangle(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 586
Protrusion of the stomach above the diaphragm, creating a bell-shaped dilation, bounded below by the diaphragmatic narrowing.
Sliding hernia(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 586
Hernia wherein a portion of the stomach, usually along the greater curvature, enters the thorax through the widened space between the muscular crura.
Paraesophgeal (rolling) hernia(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 586
Longitudinal tears along the gastroesophageal junction seen in chronic alcoholics after a bout of retching or vomiting.
Mallory-Weiss tears(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 586
Tortuous dilated veins lying within the submucosa of the distal esophagus and proximal stomach due to increased portal pressure, usually due to cirrhosis. May cause massive hemorrhage if ruptured.
Esophageal varices(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 587
Presence of eosinophils in the epithelial layer, basal zone hyperplasia and elongation of lamina propria papillae are histologic findings in this condition.
Reflux esophagitis(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 588
Defined as the replacement of the normal distal stratified squamous mucosa by metaplastic columnar epithelium containing goblet cells. A complication of long-standing GERD.
Barrett esophagus(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 591
Esophageal lesion at risk of developing adenocarcinoma:Reflux esophagitis or Barrett esophagus?
Barrett esophagus(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 589
Squamous cell carcinoma of the esophagus commonly occur at which segment of the esophagus?
Proximal 2/3 of the esophagusAdenocarcinoma- distal 1/3(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 591
Most common symptoms of esophageal cancer.
Dysphagia and odynophagia(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 591
Mucin-producing glandular tumors of the distal esophagus showing intestinal-type features.
Adenocarcinoma of the esophagus(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 591
Presence of chronic inflammatory changes in the mucosa of the stomach eventually leading to mucosal atrophy and epithelial metaplasia.
Chronic gastritis(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 592
Most important etiologic association with chronic gastritis. A non-invasive, non-spore forming S-shaped gram negative rod.
Helicobacter pylori(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 592
Gastritis resulting from production of autoantibodies to the gastric gland parietal cells, leading to gland destruction and mucosal atrophy with loss of acid and intrinsic factor.
Autoimmmune gastritis(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 592
Refers to the replacement of gastric epithelium with columnar and goblet cells of intestinal variety.
Intestinal metaplasia(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 592
A acute mucosal inflammatory process of the stomach, marked by mucosal edema and inflammatory infiltrate of neutrophils and chronic inflammatory cells. Regenerative replication of cells in the gastric pit is prominent.
Acute gastritis(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 593
One of the major causes of hematemesis, especially in alcoholics.
Acute gastritis(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 593
A breach in the mucosa that extends through the muscularis mucosae into the submucosa or deeper.
Ulcers(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 593
Breach in the epithelium of the gastrointestinal mucosa only.
Erosions(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 593
Chronic, solitary lesions that occur in any portion of the GIT exposed to the aggressive action of acidic peptic juices.
Peptic ulcers(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 594
Major cause of peptic ulcer disease in patients without H. pylori disease.
NSAID use(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 595
Histologic layers in a chronic, nonperforated, open ulcer.
From luminal surface:NecrosisInflammationGranulation tissueScar(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 596
Chief complication of peptic ulcer.
Bleeding(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 596
Increases risk of developing gastric adenocarcinoma:Acute gastritis vs. peptic ulcer disease?
Acute gastritisPUD is NOT a premalignant lesion(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 596
Acute gastric ulceration which occurs in the presence of extensive burns.
Curling ulcer(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 596
Acute gastric ulceration which occurs in the presence of injury to the CNS.
Cushing ulcer(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 596
Composed of hyperplastic gastric mucosal epithelium and an inflamed edematous stroma. A mass lesion arising from the mucosa.
Gastric polyp(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 597
Most common site of gastric carcinoma within the stomach.
Pylorus and antrum (50-60%), along the lesser curvatureCardia (25%)(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 598
What are the two most important factors in the genesis of colonic diverticula?
Focal weakness in the colonic wall and increased intraluminal pressure(TOPNOTCH)
Morphologic feature of gastric carcinomas with greatest impact on prognosis.
Depth of invasion(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 599
Gastric carcinoma confined to the mucosa and submucosa, regardless of the presence or absence of perigastric LN metastasis.
Early gastric carcinoma(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 599
Gastric carcinoma which has extended below the submucosa into the muscular wall.
Advanced gastric carcinoma(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 599
Three macroscopic growth patterns of gastric carcinoma.
Exophytic - protrusion of mass into lumenFlat or depressed - no obvious tumor mass within the mucosaExcavated - a shallow or deeply eroded crater(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 599
Rigid and thickened stomach, secondary to extensive malignant infiltration.
Linitis plastica(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 599
Histologic classification of gastric carcinoma composed of malignant cells forming neoplastic intestinal glands resembling colonic adenocarcinoma. Associated with H. pylori induced chronic gastritis.
Intestinal variant(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 599
Histologic classification of gastric carcinoma composed of gastric-type mucous cells that do not form glands but permeate the mucosa and wall as “signet-ring” cells in an infiltrative growth pattern.
Diffuse variant(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 599
A malignancy in the ovary that metastasized from a gastric adenocarcinoma.
Krukenberg tumor(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 599
Complete failure of development of the intestinal lumen.
Atresia(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 600
Narrowing of the intestinal lumen with incomplete obstruction.
Stenosis(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 600
Most common intestinal anomaly which results from the failure of involution of the omphalomesenteric duct, leaving a persistent blind-ended tubular protrusion as long as 5-6cm.
Meckel diverticulum(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 600
A congenital defect of the periumbillical abdominal musculature that creates a membranous sac, into which intestines herniate.
Omphalocoele(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 600
Extrusion of the intestines caused by lack of formation of a portion of the abdominal wall.
Gastroschisis(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 600
Condition that prevents the intestines from assuming their normal intra-abdominal positions.
Malrotation(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 600
Critical lesion in the development of Hirschprung disease.
Lack of ganglion cells in the muscle wall and submucosa of the affected segment.(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 601
Ischemic lesion of the intestines which extends only up to the muscularis mucosae.
Mucosal infarction(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 601
Ischemic lesion of the intestines involving the mucosa and submucosa, sparing the muscular wall.
Mural infarction(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 601
Ischemic lesion of the intestines involving all of the visceral layers.
Transmural infarct(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 601
Most common cause of transmural infarction of the intestines.
Acute occlusion of a major mesenteric artery(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 602
Development of sudden abdominal pain out of proportion to the physical signs. Sometimes accomplanied by bloody diarrhea. May progress to shock and vascular collapse within hours.
Ischemic bowel injury(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 602
A weakness or defect in the wall of the peritoneal cavity, which permits protrusion of a pouch-like serosa lined sac of peritoneum.
Hernia(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 603
A blind pouch that communicates with the lumen of the gut. Histologically describes as small, flask-like or spherical outpouchings, usually 0.5 to 1 cm diameter.
Diverticula(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 602
Telescoping of a proximal segment of a bowel into the immediately distal segment
Intussusception(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 604
Refers to twisting of a loop of bowel or other structure about its base of attachment, constricting venous outflow and sometimes the arterial supply.
Volvulus(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 604
Characterized by transmural inflammation of the bowel, associated with noncaseating granulomas and fistula formation. Intestinal walls are rubbery and thick. (+) skip lesions, creeping fat mesentery
Crohn’s disease(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 613
An ulceroinflammatory disease of the colon which is limited to the mucosa and submucosa. No granulomas, no skip lesions. High risk of carcinoma development.
Ulcerative colitis(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 614
Small, nipple-like, hemispherical, smooth protrusions of the intestinal mucosa. May occur singly or multiple.contains abundant crypts luned by well-differentiated goblet or epithelial cells separated by scant lamina propria.
Hyperplastic polyps(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 617
Hamartomatous proliferations mainly of lamina propria, enclosing widely spaced, dilated cystic glands. Occur most frequently in children younger than 5 years old.
Juvenile polyps(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 618
Most common type of intestinal adenoma, which are tubular glands with slender stalks and raspberry-like heads composed pf neoplastic epithelium forming branching glands lined by tall, hyperchromatic cells.
Tubular adenomas(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 618
Larger, more ominous intestinal epithelial polyp. Tends to occur in older persons at the rectum or rectosigmoid. Sessile, velvety and cauliflower-like mass projecting 1-3cm above the surrounding mucosa. Frondlike villiform extensions covered by dysplastic columnar epithelium.
Villous adenomas(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 618
Composed of broad mix of tubular and villous areas, an intermediate between tubular and villous lesions.
Tubulovillous adenomas(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 618
Uncommon autosomal dominant disorder with propensity for malignant transformation. Patients with this disease typically develop 500 to 2500 colonic adenomas that carpet the mucosal surface.
Familial adenomatous polyposis(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 619
Uncommon hamartomatous polyps associated with melanotic mucosal and cutaneous pigmentation. Caused by germ-line mutations in LKB1 gene.
Peutz-Jeghers syndrome(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 619
Polypoid, exophytic masses that extend along the wall of capacious cecum and ascending colon. Symptoms of fatigue, weakness and iron deficiency anemia.
Right sided colorectal carcinoma(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 623
Annular, encircling lesions, “napkin-ring” constrictions of the bowel and narrowing of the lumen. Symptoms pf occult bleeding, changes in bowel habit or crampy left lower quadrant discomfort.
Left-sided colorectal carcinoma(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 623
Tumor of the small intestines, showing spindle cells with elongated nuclei with fine chromatin and eosinophilic fibrillar cytoplasm. (+) c-KIT gene mutation
Gastrointestinal stromal tumors (GIST)(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 628